Can the clinical examination diagnose left-sided heart failure in adults?

Defining Diastolic Heart Failure

“…Less diagnostic certainty exists in such patients Table 4). The presence of markedly elevated blood pressure during the episode of CHF favors a diagnosis of DHF 30 because a failing LV with systolic dysfunction is more likely to result in a normal or low blood pressure. 31 Echocardiographic evidence of moderate concentric hypertrophy without concomitant wall motion abnormalities increases the likelihood of DHF.…”

“…In the second case, the possibility exists of falsely diagnosing LV diastolic dysfunction when LV systolic dysfunction is present. Findings associated with an increased probability of SHF include an abnormal apical impulse (especially sustained duration) 30,31 and electrocardiographic evidence of an old anterior Q-wave myocardial infarction or a left bundle branch block pattern. 30 …”

Keeping the culture alive: the laboratory technician in mid-twentieth-century British medical research

“…Symptoms and signs may indicate the possibility of heart failure, but are not reliable for establishing the diagnosis. 21 Chest x rays are often cited as useful in diagnosis, but a normal result does not exclude heart failure. 22 23 The main option in primary care is believed to be an ECG, since a normal recording will, in most cases, exclude left ventricular dysfunction.…”

Heart failure: why and how to define it?

“…The difficulty inherent in establishing criteria for abnormal cardiac function has led to definitions which state the required function of the heart in non-specific terms and essentially define heart failure on the basis of symptoms and signs. Signs of heart failure, when elicited, are relatively specific but lack sensitivity [11]. Subjective definitions based solely on clinical assessment are more flexible but inevitably lead to inclusion of patients with little or no objective evidence of cardiac dysfunction.…”